Hypotrophy in children. Hypotrophy in children: causes and treatment for underweight in a child. What is the reason that a child is underweight

Body weight is an important criterion for the development of a baby. Birth weight is included in the mandatory primary system for assessing the baby’s condition - the Apgar scale. How a baby gains weight after birth is important in determining its general condition, which is why the baby is weighed at every pediatrician appointment.

In this article we will talk about age-specific weight standards, and also give the opinion of the famous pediatrician Evgeniy Komarovsky on what to do if a child is overweight or does not gain the required weight.

About the norms

All children are individual, and this also applies to weight. Some are born large, while other newborns born at the same time weigh less and there is nothing unusual in this, because their parents are different (big and thin, tall or short). Birth weight plays an important role for premature babies; the degree of prematurity is determined by it, as well as by the exact gestational age.

Normal weight for a full-term baby is on average 2.6-4 kilograms. The range of normal values ​​is quite wide.

After birth, weight gain will be monitored monthly for up to a year.

Unlike height, which is a more stable indicator of the correct development of a baby, his body weight can be more labile: weight decreases or increases under the influence of various reasons. Even within the same day, Komarovsky said, parents can see different readings on the scale.

• if the child is under one year old, then his weight is m+800n, where m is birth weight, and n is age in months;
• if the child is already one year old and up to the age of ten, they use another formula, in which the normal body weight is 10 + 2n, where n is age in years;
• if the child is over 10 years old, then for the calculation they use a formula in which the normal weight is 30 + 4 * (n-10), where n is age in years.

Thus, it is easy to understand that a baby at 7 months, if he was born weighing 3500 grams, should weigh no less than 3500+ 800x7, that is, 9 kilograms 100 grams. A 2-year-old child weighs 10+2x2, that is, 14 kilograms. Just plug in your values ​​and you can focus on the norm.

You can make it simpler and use a table or calculator for height and weight depending on age. Pediatricians also use tables at appointments, since this significantly reduces the time a child is seen, because the doctor does not need to do mathematical calculations.

Naturally, if the norm is significantly exceeded and in situations where the child is not gaining weight well, you need to carefully consider and eliminate the possible reasons why this is happening.

Height and weight calculator

Reasons for the lag

The most active weight gain occurs in the first six months of a child’s life, then the pace slows down, because the child’s physical activity increases - he learns to crawl, sit, and this requires large energy expenditures. Low birth weight children sometimes gain weight more actively than babies born rich; the gain in such babies can be more intense.

A significant lag in real body weight from the norm can be a consequence of malnutrition and malnutrition, diseases of the gastrointestinal tract, as well as any other congenital or acquired diseases.

Naturally, the pediatrician will identify the causes, prescribe tests, and give recommendations on diet.

If a child is slightly behind the norm in weight, but he is active, mobile, inquisitive, feels great and has normal tests, there is nothing to worry about, says Komarovsky. It is dangerous if a small increase and a lag behind the standards are accompanied by pallor, lethargy, and some other symptoms that make parents think about a possible illness, it is important to immediately go to the doctor, says Evgeny Komarovsky.

Complaints from parents that the child has a big belly at 2 years old and weighs 10 kg, as well as that the child at one year old weighs only 8 kilograms instead of the required 10, should be considered in each specific case, taking into account a complete medical history. The doctor needs to know what weight the child was born with, how he feels in everyday life, and also see what build the parents have.

It is quite clear that a sharp decrease in body weight can be a sign of quite serious diseases and common helminthic infestations, and therefore laboratory diagnostics in this case cannot be avoided.

For parents of little ones who eat little and not every time, Komarovsky advises to calm down and stop trying at any cost to fatten the child up to the age standard. The approach is the same: if you feel normal and healthy, then you don’t need to do anything to correct it.

Why does the excess occur?

Excessive weight gain is most often due to the fact that the baby’s parents overfeed. Excess weight is formed when the degree of energy expenditure does not correspond to the amount of food received. An infant who sleeps most of the day gains weight better and faster than an active and moving two-year-old.

Fluctuations in weight up (or down) are also possible during intense hormonal changes, for example, this is how a teenager loses weight or gains weight during puberty. Some pathologies of the thyroid gland and other endocrine disorders can cause childhood obesity, but this happens much less frequently than the banal and widespread overfeeding of a beloved child.

A child over 2 years old may be overweight due to a sedentary lifestyle and little activity; the risk of acquiring extra pounds is higher in children who are allowed to eat and drink unhealthy but very tasty fast food, lemonade, and chips.

What to do? Show your child to a doctor, if necessary, examine him, do blood tests, check the functioning of the gastrointestinal tract and receive recommendations for smooth and careful weight loss.

An adequate increase in physical activity while stopping the practice of force-feeding usually helps. Evgeniy Komarovsky advises giving food to a child only when he himself asks for it.

You cannot feed your child in front of the TV screen: being carried away by the picture, he eats more than what he should.

Parents should also pay attention to their own eating habits; poor nutrition usually runs in the family. Fatty and fried foods, smoked foods, spicy foods, fast food, and an abundance of sweets should disappear from the child’s diet. Instead, vegetables and fruits, stewed, boiled and baked meat and fish should come. It is worth giving up lemonade and various store-bought sweets.

Why is it important to monitor your child's weight? Excess weight is dangerous at the stage of starting to walk, because it creates increased stress on bones, joints, cartilage, ligaments and the spine. In children with excess body weight, flat feet are more often registered at a later age. Obesity is fertile ground for the development of various diseases, as well as a factor in reducing immunity.

For more information about weight standards, see the next program by Dr. Komarovsky.

If one person, following a certain diet, quickly gains the missing kilograms, it is quite possible that it will not help another at all. Therefore, before choosing a diet, it is necessary to find out the cause of the defect.

All causes of weight deficiency can be divided into 2 large groups - psychological and physiological.

The baby may be underweight even before birth. In this case, hereditary predisposition matters.

According to doctors' observations, about 10% of children in Russia are stunted in height and weight.

Numerous studies have revealed that a person's weight often depends on the weight of his parents. If parents are thin, the likelihood that their child will also be thin in the future increases by 70-80% compared to those children whose parents were overweight.

Underweight babies may also be born due to various complications during the mother's pregnancy. If one parent is underweight and the other is overweight, the child will most likely be born underweight. But this situation will change quickly. Such children begin to gain weight very quickly, and soon their weight returns to normal, so there is no need for any special diet.

If a woman has been treated for infertility for quite a long time, there is also a high probability that she will give birth to an underweight child. The same situation occurs if a woman took hormonal drugs during pregnancy. Such children need a special diet, and from birth they must be observed by an endocrinologist and pediatrician. It is better not to experiment with your baby’s diet on your own. In such cases, doctors need to tell you exactly what medications you took before and during pregnancy.

A very early transition to artificial feeding contributes to low baby weight. A breastfed baby gains weight faster than a formula-fed baby. This is due to the fact that mothers who breastfeed try to feed their baby more often and for longer, while mothers who feed their baby formula give it to their baby a little less often.

Underweight in a child can also be caused by poor nutrition. A properly balanced diet affects the normal growth, weight and development of the child. If you are concerned about any questions, for example, a child of average height weighs very little, be sure to consult a doctor.

For the normal development of a child, the following calorie content is required:

from birth to 9 months – 110-125 kcal per 1 kg of weight per day;

from 9 months to 1 year – 100-110 kcal per 1 kg of weight per day;

from 1 to 1.5 years – 90-100 kcal per 1 kg of weight per day;

from 1.5 to 4 years – 80-90 kcal per 1 kg of weight per day;

from 4 to 8 years – 70-80 kcal per 1 kg of weight per day;

from 8 to 12 years – 60-70 kcal per 1 kg of weight per day;

over 12 years old – 50-80 kcal per 1 kg of weight per day.

Using these data, it is easy to create a daily diet for a child with the amount of calories he needs.

However, it is known that not only the calorie content of food is important. Complete food for a child, as for an adult, should contain fats, proteins, carbohydrates, vitamins, minerals and water.

A large percentage of low birth weight babies are born when the baby's mother is short and the father is overweight. In the future, such children, on the contrary, will have extra pounds.

An improper diet can cause various diseases of the gastrointestinal tract, which also leads to weight loss in both adults and children.

Sudden weight loss may be a consequence of any disease, especially one that is chronic. To gain the missing kilograms, you must first eliminate the cause, that is, cure the disease, and then normalize your weight with the help of a diet.

Weight loss can be caused not only by chronic, but also by frequently recurring infectious diseases. If your child gets colds frequently, he or she may experience gradual weight loss. Once recovered, the child will quickly gain weight, even without following a special diet.

It is well known that a person grows unevenly at different periods of his life. He also gains weight unevenly. Growth spurts lead, accordingly, to changes in body weight. Most often in a person’s life there are 3 such jumps in height and weight.

The first such jump occurs at the age of 8-10 months. During this period, the child experiences increased activity. He learns to crawl and then walk. At this time, the center of gravity in the body shifts, resulting in a redistribution of the load on the skeletal muscles.

The folds on the skin characteristic of babies are reduced, and parents think that the child has lost weight. However, this situation is completely normal. Starting from 8 months, the child gains weight approximately 2-2.5 times less than before. At this time, the main task of parents is not to overfeed their child.

Starting from 11-12 months, the child is gradually transferred to adult food. Make sure your child does not eat foods that are too high in calories. This is very harmful to the stomach.

The second growth and weight spurt occurs at around 3 years of age. At this time, the child is very active, runs and jumps a lot. If over the past six months he has gained almost no weight at all, now he is beginning to intensively gain both centimeters and kilograms.

If a child recovers too quickly or, conversely, does not gain weight at all, this is a reason to consult a doctor. At this age, try to create a balanced diet for your child, do not feed him too much, but also do not starve him. Remember that with the increased physical activity inherent in this age, a large number of calories are burned, the supply of which must be replenished.

The third growth spurt occurs at the age of 7 years. If a child is underweight at this age, this is most often due to a psychological factor. Starting school is inevitably associated with stress, changes in daily routine, fear of not being able to cope with homework or not having time to change clothes for physical education class, etc.

Due to hormonal imbalances, a person may also experience weight loss. Hormone levels are checked using a blood test.

A child's weight in first grade may change by 20-25% compared to what he was before school. Having adapted to school, the child, as a rule, stops losing weight and his weight gradually returns to normal. The main thing during this period is not to overfeed the child. His diet should be rich in food containing proteins, fats, carbohydrates, vitamins and minerals.

There is a special formula to calculate the optimal weight of a child. To determine the weight of a child under 6 months of age, multiply 800 g by age in months and add to birth weight.

B = 800 x Chm + Bp, where B is the weight of the child, Chm is the number of months, Bp is birth weight.

The weight of a child aged 7 to 12 months is calculated as follows: 800 g must be multiplied by 6, 400 g multiplied by the number of months after six months, the resulting two numbers are added and the child’s weight at birth is added to the sum:

B = 800 x 6 + 400 x Chm + BP, where B is the weight of the child, Chm is the number of months after six months, BP is birth weight.

If you discover that your child is underweight, after consulting with your doctor, you need to review his daily diet. Lack of weight in a child is called malnutrition. Such children are very vulnerable; their thermoregulation process is often disrupted. Hypotrophy is also accompanied by a decrease in immunity.

Hypotrophy is caused by the intake of nutrients into the body in insufficient quantities or their improper absorption.

Most often, malnutrition is observed in children of the first year of life and, depending on the time of occurrence, can be congenital or acquired. Congenital malnutrition is most often associated with improper nutrition of a pregnant woman. Acquired malnutrition is caused by improper feeding of the child or underfeeding.

A pregnant woman's diet can also affect her baby's weight if she wants to gain weight after the baby is born. Studies have shown that women who decide to become pregnant are advised to gain some weight. If a woman gains a few pounds before pregnancy, this will significantly increase her chances of having a normal-weight baby, while women who lose weight before pregnancy often give birth to underweight babies.

It is important to eat right during pregnancy. Insufficient or inadequate nutrition harms not only the woman herself, but also the unborn child. Among children born with low weight, there is a very high mortality rate in the first days after birth. Even if the child survives, there is a high probability that in the future this will affect his mental and physical development.

A woman who has gained a few kilograms before pregnancy increases her chances of having a normal-weight baby by 20%. If a woman gained at least 250 g weekly during pregnancy, the likelihood that the born child will have a normal weight increases by 90%.

There are three degrees of malnutrition in a child.

I degree

In all areas of the body except the face, the thickness of subcutaneous fat tissue decreases. First it starts to emaciate on the stomach. At the level of normal height gain, weight gain slows down or stops. Neuropsychic development corresponds to the child’s age. After some time, the child begins to have sleep and appetite disorders.

II degree

Subcutaneous fat tissue practically disappears on the abdomen and chest, and it also decreases slightly on the face. The child begins to lag behind his peers in growth and neuropsychic development, becomes lethargic and indifferent, and his appetite disappears. Vitamin deficiency begins.

III degree

Subcutaneous fat tissue disappears in all parts of the body; only a thin layer on the cheeks may remain. Body weight is 30% less than normal and is constantly decreasing. Breathing disturbances are sometimes observed.

The mucous membranes are dry and bright red. Reduced heart rate and blood pressure. The child needs urgent treatment.

At the first signs of malnutrition, the child should be shown to a doctor. In case of malnutrition of the first degree, outpatient treatment is indicated for the child; in case of degree II and III - inpatient treatment. The main way to treat malnutrition is proper nutrition and elimination of its cause. Hypotrophy can occur not only as a result of diseases of the digestive system, but also other systems of the human body.

Acquired malnutrition in a child can be caused not only by malnutrition, but also by various intestinal infections.

Various defects of the digestive tract that cause insufficiency or spasms (achalasia, pylorospasm, etc.) are the causes of malnutrition. The child’s body does not accept food well and, as a result, lacks it.

The occurrence of malnutrition is also influenced by anatomical malformations (duodenostasis, short esophagus, pyloric stenosis, etc.). They cause upper or lower intestinal obstruction, which manifests itself in changes in stool, nausea, etc. In rare cases, intoxication of the body occurs.

Forms of congenital hypotrophy:

neuropathic hypotrophy. The child does not lag behind in growth and mental development, and at the same time he does not feel hunger;

neurodystrophic hypotrophy. The child has a negative attitude towards food, is very excitable and irritable. He is stunted in growth and psychomotor development;

neuroendocrine hypotrophy. Along with a slight lag in weight, there is a significant delay in the child’s growth;

encephalopathic hypotrophy. The child is indifferent to food and has no sucking reflex.

To cure a child, it is necessary, with the help of doctors, to create the right diet. Try not to force-feed your baby, as this can have the opposite effect and only make the situation worse.

The child’s daily diet is based on two important principles:

“rejuvenation” of food, that is, the child should be fed the same way you fed him when he was very small. The diet should include breast milk and various milk formulas;

two-phase nutrition, that is, before transferring the child to optimal nutrition, it is necessary to adapt it to proteins, fats and carbohydrates, gradually increasing their amount.

The term “hypotrophy” was introduced in 1900. However, the disease itself was often encountered earlier.

In order to adapt a child to “adult” food and increase his weight, you must first relieve his digestive system as much as possible. To do this, gradually reduce the daily amount of food until it is equal to one to two thirds of your normal diet. Take the rest with plenty of liquid - tea, juices, vegetable or rice broth.

Having unloaded the child’s digestive system, proceed to the next stage, gradually increasing the daily amount of food. At the same time, make sure that the animal protein content in your diet increases gradually and in very small doses.

At the next stage, add cottage cheese, vegetable oil, kefir, fruit purees, and cream to the child’s diet. If the child’s weight begins to increase, complementary foods can be introduced into the diet - porridge or vegetable puree with vegetable broth.

While the child is following this therapeutic diet, pay attention to his condition - is there any nausea, vomiting, regurgitation, is the child eating the daily norm, is the stool normal, etc.

However, such foods should not be given to newborns, although they may also be underweight.

In general, underweight children need foods with higher protein content. This will ensure the child's rapid growth and weight gain. Most doctors recommend feeding an underweight child food rich in proteins, up to 2 weeks of age - 2.5-3 g per 1 kg of body weight, up to 1 month - 3-3.5 g, and over 1 month - 3.5 -4 g.

The fat requirement for children with insufficient body weight is 5-6.5 g per 1 kg of body weight, approximately the same as for children with normal weight. In order for the child to receive a sufficient amount of fat, along with breast milk, he must be fed with various mixtures that include vegetable fats. Due to a mixture of vegetable and animal fats, about 40-50% of the total calorie intake is provided.

A child's carbohydrate requirement is approximately 12-15 g per 1 kg of body weight. Most pediatricians advise reducing the content of products containing lactose in the child's diet.

The need for mineral salts in underweight children is greater than in normal children. Products containing calcium must be present in the child’s diet in an amount equal to approximately 130-150 mg per 100 kcal, magnesium - 6 mg per 100 kcal.

Vitamins enter the baby's body through breast milk. Vitamin E is especially important. A sufficient daily dose is about 1 mg/100 kcal.

When breastfeeding, the optimal ratio of proteins, fats and carbohydrates is 1: 3: 6, when artificial - 1: 1.5: 3.5.

With a properly formulated diet, the child’s weight begins to increase after 3-4 weeks. Don't forget to show it to doctors regularly. Do not experiment with your child’s diet; if you decide to introduce something new into the diet, consult your pediatrician. In any case, introduce each new product into the diet gradually, in very small quantities.

If the mother does not have enough breast milk during this period, the baby must be supplemented with formula milk. Usually, breast milk is analyzed and if there are insufficient quantities of certain nutrients, they are prescribed additionally:

for protein deficiency - cottage cheese, kefir, milk;

if there is a deficiency of fats - 10-20% cream;

if there is a carbohydrate deficiency - water with added sugar syrup.

If the condition is critical, nutrients may be given intravenously. In case of malnutrition, vitamins and various enzymes (pepsin, abomin, pancreatin, festal, panzinorm, etc.), as well as stimulants (dibazol, apilak, etc.) are added to the child’s diet.

To prevent malnutrition in a child, special attention should be paid to the mother’s nutrition during pregnancy. Careful monitoring of her weight, as well as the weight of the baby after birth, is important. A nursing woman must correctly create a diet for both herself and her baby and follow it exactly.

If a woman suffers from a lack of vitamin D during pregnancy, this increases the likelihood of having an underweight baby.

When switching your child to adult food, try to include in the diet all the necessary foods rich in proteins, fats and carbohydrates. If the family adheres to any peculiar way of eating (vegetarianism, raw food diet, therapeutic fasting, etc.), it is completely unacceptable to accustom a child to this. The child should eat adequately for his age. You can switch to any specific methods of nutrition only after the end of the growth period.

You can feed your child a very tasty dish prepared according to the following recipe:

Curd balls

Ingredients: 200 g cottage cheese, 2 teaspoons semolina, 1 egg, 10 g sugar, 100 g berries (raspberries, blueberries, currants, etc.).

Cooking method. Grind the cottage cheese with the egg yolk, add semolina, beaten egg white, sugar and berries. Mix everything thoroughly. Heat 1 liter of water, add a little salt. Take a teaspoon of the resulting mass and carefully lower it into boiling water for 1-1.5 minutes. Serve the balls warm, you can add a little butter or sour cream and sprinkle with powdered sugar.

Nutrition for older underweight children is somewhat different from nutrition for toddlers.

The child continues to be in a stage of intensive growth. At this stage, the body's need for proteins increases even more. Previously, protein entered the child’s body along with mother’s milk, then with cottage cheese and cow’s milk. Now you need to gradually accustom your child to meat. Meat is a good source of proteins that take part in the construction and renewal of body cells. This is very beneficial for a growing body, especially for underweight children.

Until the age of 1 year, gradually include beef in your child’s menu; sometimes he can be given dishes made from lean pork and white meat chicken. After some time, when the child’s body adapts to meat, include lean fish in the diet.

In order for a child to gain weight, meat dishes must be thoroughly chopped - otherwise it will be difficult for the baby to chew them. Clean the meat from films and veins and pass through a meat grinder several times.

If your child doesn’t like this dish, mix minced meat with vegetable puree. At 8 months, the daily portion of meat should not exceed 30 g. After 1-2 weeks, when the child gets used to meat, it can be given separately. To prevent the meat from becoming dry, you can boil it and then simmer it in milk for a while.

You can make meatballs for your child, just cook them in such a way that they are more crumbly. When your child turns one year old, you can give him steamed cutlets. By eating this way, the child will quickly gain the missing kilograms.

Vegetable oil must be present in the diet of an underweight child. Without vegetable fats, its normal growth and development is impossible. But don’t get carried away: a child should receive no more than 0.5 teaspoon of oil per day with food. Make sure your child eats the bread, especially the crust.

To help your baby gain weight faster, feed him often, but little by little. It is best to stick to a four-hour interval - at 6.00, 10.00, 14.00, 18.00, 22.00. Do not overload the baby’s stomach; give him breast milk or various formulas during the first and last feeding, otherwise, instead of weight gain, you will achieve the opposite result. Make the menu for the second feeding from fruit or berry purees. You can give milk porridge. Give meat with vegetable puree at the third feeding, and juice or compote for dessert. Remember that for 1 feeding the child can eat no more than 200 g. In the evening, you can give cottage cheese or kefir. Between feedings, the baby should receive enough drinking water.

“Doctor, we have terrible problems - the child often spits up, he has unstable stools with lumps, his stomach often hurts”
- “And how is the weight increasing?”
- “Everything is fine with my weight - I gained 2 kilograms in the first month of my life”
- “Then I have to disappoint you, the child is completely healthy. If there is weight gain, then what kind of stool he has, how often he spits up does not play any role.”

Unfortunately, there are situations when, on the contrary, weight gain is poor, despite the fact that the child seems to be eating normally. But what does “bad” mean and when should you start worrying?

In general, the weight of children during the first year of life increases approximately 3 times - from 3 kilograms at birth to 10.5 by the year of life. Thus, daily weight gain in the first 3 months of a child’s life is about 30 grams per day, then from 3 to 6 months babies add about 18 grams per day, from 6 to 9 months - 12 grams, from 9 to 12 months - 9 grams .

There are special centile tables, with which you can determine whether the child’s weight and other parameters are within normal limits. If the patient’s weight is below the 3rd percentile or is less than 20% of the average age norm, it means that there is a clear deficiency of weight and it is necessary to understand the cause of the deficiency.

The reasons are sometimes quite obvious. For example, if a child has frequent, oily, shiny stools and recurrent pneumonia since birth, cystic fibrosis may be suspected.

And if weight gain stops after six months of life, soon after the introduction of wheat porridge, along with upset stools, you can think about celiac disease. Persistent loose stools in a previously healthy child may indicate giardiasis.

But there are situations when an apparently absolutely healthy child does not gain weight for a seemingly completely incomprehensible reason. Let's see why this happens.

Until now, some midwives and neonatologists in maternity hospitals recommend feeding a newborn baby at least every 3 hours (“so that it is well digested”) and not feeding at night (“so that the stomach can rest”). But the baby’s stomach is still too small and cannot always last 3 hours without food, let alone a night break.

It also happens that a child is deliberately underfed. For example, when a mother is irrationally afraid that the child will grow up fat, this is especially true for bottle-fed girls. But I assure you that such fears are completely unfounded.

Signs of the problem of “underfeeding”: the child eats greedily, cries loudly and demandingly between feedings, pees little and rarely poops. The solution to the problem is simple - establish feeding on demand, and begin to establish a regimen closer to 2 months of life.

Lack of breast milk

Modern women have problems with lactation much more often than before. This is especially common when the child is the first, the mother is inexperienced and anxious. It also happens that a woman is fanatical about breastfeeding and believes that if she does not breastfeed, then she is a bad mother. Such a mother cannot even admit the thought that the child can be supplemented with formula.

As a result, the baby hangs on the chest from morning to night and does not let go of the mother, there is not enough milk, the baby’s weight does not increase. Here it is necessary to understand that such a strategy is not beneficial for either the child or the mother. After all, breastfeeding does not lose its importance due to the small volume, and if you supplement with formula, the benefits of breastfeeding remain. This means that additional feeding can and should be done.

A situation regularly occurs when a mother, experiencing stress, copes with it by constantly putting the baby to the breast. Often these are the very cases when she sleeps with the child in the same bed, and dad moves into the next room. Such a mother is afraid to reduce the number of feedings even as the baby grows up. And the situation turns out that a child in the second half of life, who is breastfed every free minute, refuses to eat solid foods (complementary foods) even when he is completely ready for them.

Sometimes, “under pressure” from a pediatrician who insists on complementary feeding, the mother, so be it, offers the child new food, but seeing a negative reaction (after all, the baby is stuffed to the brim with milk), she confidently refuses to introduce new foods.

However, after 6 months of life, breast milk does not meet the baby's needs. As a result, he does not come off the chest and does not gain weight. Often the only way out in this situation is the birth of a second child or going back to work. Another option is to improve your relationship with your husband.

Sweet liquids

Another typical situation is when a child is introduced to sweet juice or compote almost from 2–3 months of age. Initially, this is usually associated with grandmother’s false confidence in the benefits of these drinks.

High-calorie sugar suppresses appetite, but does not meet the child's nutritional needs. In addition to poor weight gain, abuse of compotes and juices causes caries and constipation.

In general, if a healthy baby is not gaining weight well, you should not drag your baby to more and more doctors, who sooner or later will “find” something and will “treat” you for your money, but look for the reason in your parental troubles and prejudices - most likely, that’s where it will show up.

Mikhail Nikolsky

Photo istockphoto.com

Weight is the main indicator of a baby’s health, which is why when visiting a pediatrician, the child is first weighed and then examined.

Particular attention is paid to underweight in infants - since this indicator should increase proportionally with age.

Deviations can be in two directions - excess body weight or deficiency. If the weight is too high, the doctor advises you to adhere to the feeding regime, but underweight can be a very alarming signal.

Lack of weight is malnutrition. It is very dangerous, since as a result, severe and not entirely pleasant symptoms can develop in the child. When a baby is constantly growing, the development of organs and tissues requires a constant supply of energy and “building material.”

The source of all this is food. When a child lacks nutrients, the body may require them from its reserves.

As a result, with a slight weight loss, the following is noted:

• frequent tendency to ARVI;
• rickets;
• anemia;
• endocrine dysfunction;
• dysbiosis.

Various external manifestations will be noticeable not only by the doctor, but also by the parents.

Infants have a special sensitivity to nutrients, therefore, against the background of malnutrition, they often experience delays in the formation of tissue organs, pathologies of the musculoskeletal system, and lags in neuropsychic development. It is very important to consult a doctor in time to prevent the development of abnormalities.

It is impossible to compensate for the lack of available substances, since they accumulate in the body progressively.

How to determine underweight?

Low weight compared to the age norm does not always indicate the presence of malnutrition.

It may also be related to the following factors:

• Constitutional features. In families where parents have a lot of weight, overweight children are born, and vice versa. Often weight indicators are a hereditary phenomenon.
• Features of feeding. A breastfed child may sometimes lose weight compared to children who are on mixed or artificial nutrition.

Periodic weighing will help prevent health problems in your baby.

External causes of underweight in infants

External reasons may be due to the wrong actions of the parents or the environment that surrounds the child.

Often these reasons include:

• Nutritional factor. Breast milk is not enough to keep your baby full and gain weight. This is due to the improper nutrition of the nursing mother - the child consumes enough milk, but it is not nourishing for him. There may also be very little milk.
• Eating disorders.
• Wrong mixture for artificial feeding can also affect weight, as can the late introduction of complementary foods.
• Toxic factor You can name unfavorable ecology, taking medications, frequent poisoning and lack of sufficient vitamins. It is necessary to reconsider taking medications that help strengthen the immune system and other body functions.
• Social factor is that parents are inattentive to their baby - he rarely goes for walks, communicates little with mom and dad, and does not receive affection. No one gives him a massage or performs developmental gymnastic exercises - all this can lead to improper development of the baby and weight abnormalities.
• Exogenous factors cause enormous stress - the child often wakes up at night, eats poorly and behaves restlessly when the environment changes.

Internal reasons

Internal causes are pathologies of the body. This may include:

• ARVI and other diseases of a similar nature.
• Intestinal pathologies and infections.
• Lack of nutrients and poor metabolism.
• Malformations of the central nervous system and endocrine diseases.
• Immunopathological processes, the presence of allergies.
• A hereditary disease that occurs with malabsorption syndrome.
• Cystic fibrosis or dysfunction of the exocrine glands.

In the first two weeks, a child can lose up to 10% of his weight. This is quite normal. At this moment, the baby gets used to extrauterine life, adapts, so all excess fluid is eliminated.

Signs of being underweight

When examining a baby with malnutrition, you can see that the child’s body lacks vitamins and nutrients.

The subcutaneous fat layer becomes thinner, folds and cheeks disappear, and thinness is observed.

The skin becomes flabby, dry, flaky, and its turgor decreases.

As for nails and hair, they become brittle and lose their beauty. Nervous system disorders and sluggish reflexes are observed.

Data from laboratory tests can confirm or refute the presence of malnutrition - you can also find out the degree and causes of the development of the disease.

The baby may experience a decrease in hemoglobin, a change in the number of red blood cells and lymphocytes. In order to find out the cause, you need to take a general blood test.

Determining the normal weight of an infant

The neonatal period lasts 28 weeks, starting from the moment the baby is born.

Over the entire period of time, he gains 1/3 of his weight, namely 20 grams every day.

The child is constantly monitored, height, body weight and other indicators are measured. Every month the increase decreases. Doctors strongly recommend feeding infants no more than once every 2.5 hours.

• This regimen will allow you to regain weight and control the amount of food according to the size of your stomach. The hourly demand for food indicates that the baby easily digested the previous portion and now wants a new one.
• During the second half of the first month, the child intensively gains weight and becomes 500-600 grams larger. This indicator is quite normal. In order to make sure that everything is going according to plan, the child is often sent for an examination, where he is recommended the best diet. A nursing woman should also eat well, since the quality and calorie content of milk depends on her food.
• From 4 to 6 months, growth decreases due to the fact that the baby becomes more mobile. 500-1000 grams are added to the weight. The permissible increase is 300 grams, but the doctor must examine and analyze the baby’s condition.
• In the period from 6 to 9 months, infants are introduced to complementary foods, and breastfeeding is continued as required. At this moment, children gain from 600 grams to 1.5 kg.
• In the period from the 10th to the 12th months, the increase should be from 300 to 900 grams. You need to feed your baby on demand, but it is better to stick to this regimen - 4 times a day. A slight weight gain during this period is due to the fact that the child begins to walk and expends enough energy.

Stable weight gain can only be ensured by artificial feeding. Every month, when examined by a doctor, the baby is weighed, weight measured and tests taken. If all indicators are normal, the baby is healthy.

How to treat underweight?

If malnutrition is detected in a child, treatment is carried out strictly as prescribed by the doctor and under his supervision.

Normalizing your diet is the first thing to do. But this is not the only parameter that is worth paying attention to.

A special diet aimed at increasing the amount of food will help the baby gain weight faster and get stronger.

As a supplement, enzymes, nutritional and medicinal mixtures, vitamins and other drugs can be prescribed. The duration of treatment for malnutrition depends on how low the baby’s weight is. If the disease is caused by internal reasons, they certainly need to be eliminated, and only then should the diet, caloric intake and amount of food be reconsidered.

In conclusion, it is worth noting that underweight in infants is a serious problem that cannot be ignored.

If a child has a predisposition to low weight, this will be noticeable even at birth. But if a baby loses weight every month, this may be a signal of a very serious problem.

In any case, contact your pediatrician so that he can conduct an examination, weigh you, and also draw conclusions about whether it is worth changing your diet and its frequency. Perhaps, in order for the child’s weight to normalize, you just need to add complementary foods to the diet and slightly modify the regimen.

Body mass deficiency (hypotrophy) is a disease that manifests itself as an eating disorder and underweight. This condition occurs in both boys and girls. In approximately 10% of cases, the child is extremely malnourished, and in 20% of cases, rickets and anemia (iron deficiency) are associated with malnutrition. Appearing in the first year of a baby’s life, malnutrition can be congenital or acquired. After a year, it is customary to talk about an acquired disease.

Causes and forms of the disease

Congenital weight deficiency can be diagnosed in children under one year of age due to the following reasons:

• mother’s age – under 20 and over 38–40 years;
• infectious diseases suffered by the pregnant woman;
• pathologies during pregnancy;
• poor nutrition of the expectant mother;
• use of drugs, alcohol and smoking, as well as exposure to occupational hazards.

Deficiency can also be acquired. The reasons are:

• underfeeding of the child: tight nipples, abnormal structure of the child’s jaw, late introduction of complementary foods, hypogalactia (lack of breast milk);
• prematurity, especially deep;
• CNS injuries during childbirth;
• pathologies of the digestive or endocrine system, pylorospasm;
• violation of the regime and rules of child care.

Stages of the disease

Hypotrophy is usually divided into 3 degrees:

1. At grade 1, the symptoms are erased: loss of appetite (usually slight), sleep disturbance, excessive excitability. The child looks thin in the abdominal area, muscle and skin tone may decrease, and infectious diseases may develop more often. Weight loss at this stage can be 11–20%.
2. With the second degree of malnutrition, the deficit will already be 20–30% of the norm. A growth retardation of 3–4 centimeters is also noticeable. The child may be developmentally delayed, sleep poorly, and have bowel movements. Children under 1–1.5 years old may burp frequently. The skin loses its elasticity and gathers in folds. Not only the stomach looks thin, but also the limbs.
3. At stage 3 of the disease, there is a noticeable delay in growth by as much as 4–9 centimeters, and in weight by 30% or more. The child is constantly sleepy, whiny, and gets sick very often. The hands and feet are always cold, the subcutaneous tissue is thinned, the skin takes on a grayish tint, and the mucous membranes are dry. Chronic pneumonia and pyelonephritis may occur.

Symptoms and diagnosis

It is the presence of symptoms that will help parents be wary, and the doctor will help distinguish true malnutrition from the individuality of the child’s body structure caused by hereditary factors. Depending on the stage of the disease, parents may notice the following symptoms in their child:

• the baby began to eat less: the baby does not drink the required amount of formula or spends less time at the breast, an older child leaves part of the portion on the plate in the absence of snacks;
• sleep has become superficial, weak, the child often cries both day and night for no reason;
• the skin becomes dry, inelastic, pale;
• diarrhea or constipation appears;
• emotional and physical activity decreases;
• The baby’s limbs are often cold;
• the child gets tired quickly and refuses active games.

There are several ways to diagnose underweight. The pediatrician must collect anamnesis: the patient’s diet, congenital pathologies, chronic diseases, and the general situation in the family. Visual examination: condition of the skin, hair, teeth, nails, muscle tone. Be sure to weigh yourself and determine your body mass index.

Additionally, laboratory methods are used: general tests of stool, urine, blood, ultrasound of all abdominal organs, respiratory test, ECG, blood biochemistry and immunological examination. If a pathology that has led to malnutrition is identified, additional examinations are carried out.

Deficiency can be determined by calculating BMI (body mass index). The indicator takes into account the ratio of weight and height and can determine underweight or overweight. The deficit is calculated using the formula: divide the child’s actual weight in kilograms by his height in meters twice. For children, depending on age, the normal BMI is in the range of 15–18.5.

Weight loss treatment

The main treatment is diet therapy. At the age of up to one year, the following diet is prescribed:

• complementary feeding is excluded for 2 days and the child is transferred to formula (breast milk) in a volume of 2/3 of the norm, 1/3 of reparation solutions;
• then gradually increase the volume of the mixture - it should reach the size that is appropriate for a baby at this age;
• complementary foods are introduced sequentially.

From one to three years of age, the diet looks like this:

• exclude spicy and allergenic foods, replacing them with cereals, boiled vegetables, lean meat and dairy products;
• 1/3 of the diet is replaced with drinking solutions or vegetable decoctions, compotes, fruit drinks;
• then determine the norm for the amount of food that corresponds to the child’s desired weight, and gradually increase the portions.

Drug treatment involves taking the following drugs:

• pancreatic enzymes;
• drugs against dysbacteriosis;
• vitamin complexes;
• means to increase appetite;
• immunomodulators;
• drugs that correct the baby’s individual disorders (prevention of anemia, reduction of excitability);
• at 3 degrees of malnutrition, anabolic steroids are prescribed, which help in the formation of protein to increase muscle mass.

Hypotrophy of 2 and 3 degrees is treated only in a hospital under the constant supervision of specialists. Diet therapy produces results within 1–4 months, depending on the stage of the disease. Meals are only fractional, in small portions. Additionally, massages, ultraviolet irradiation, and exercise therapy are indicated. In advanced cases, tube feeding is used.

Preventive measures

Timely treatment of stage 1 and 2 weight deficiency leads to complete recovery without consequences. The third stage of the disease is the most dangerous: the mortality rate reaches 50%. Congenital (prenatal) malnutrition is excluded by establishing the daily routine and nutrition of the pregnant woman, taking vitamins, monitoring the pregnancy in a antenatal clinic with constant monitoring of the weight and condition of the fetus.

It is imperative to establish breastfeeding after the baby is born. Frequent breastfeeding on demand is an excellent prevention of malnutrition. It is important to introduce complementary foods on time. The first products may be a special baby porridge or vegetable/fruit puree. The first complementary foods should be offered to the baby no later than 6–7 months.

Underweight in adolescents

Weight loss is common during adolescence. Most often - at 11–16 years old. During puberty, a child may grow rapidly, while muscle mass will increase more slowly. A hormonal disorder may occur, for example, hyperthyroidism, in which weight loss is also observed.

One of the common reasons is psychological. This is especially true for young girls who consider themselves too fat. Anorexia nervosa is a disease that leads to obsessive thoughts about losing weight. A teenager may refuse to eat and provoke vomiting after eating, which inevitably leads to malnutrition. This condition requires not only drug treatment, but also psychological correction.